Fifteen top doctors have called on the government to use Brexit as an opportunity to tackle antibiotic resistance in agriculture.

The call, made in a letter published in The Telegraph on Monday and timed to mark the start of World Antibiotic Awareness Week, also coincided with an agreement to tackle antibiotic resistance in the environment struck by UK and Chinese scientists at a high level meeting at the end of last week.

Signatories to the letter include the President of the Royal Society of Medicine - Babulal Sethia, the President of the British Medical Association - Professor Pali Hungin, and the Presidents of ten Royal Colleges and Societies. They said the government should use Brexit to ban the routine mass use of antibiotics, in a bid to tackle growing resistance to even last-resort treatments.

Experts, including the UK’s Chief Medical Officer Prof Dame Sally Davies, have said antibiotic resistance is on par with climate change in terms of the threat it poses to humans, and in May a major government-commissioned report on resistance found that the annual death toll from infections with antibiotic resistant bacteria could rise from around 700,000 deaths today to 10 million by mid-century. Lord O’Neill, who led the review on Antimicrobial Resistance (AMR) said in May that immediate international action is needed to prevent the world from entering a post-antibiotic age.

Overuse in farming behind growing resistance to antibiotics
 
The senior medics’ letter in the Telegraph warns that overuse of antibiotics in agriculture is behind much of the growing resistance seen in bacteria, a view shared with the team of scientists who discovered bacteria resistant to the ‘last resort’ antibiotic family polymyxins late last year.

Industry groups, including the Responsible Use of Medicines in Agriculture Alliance (RUMA) which includes vets’ groups and the NFU, have played down the role of farming in the development of antibiotic resistance, warning that a blanket ban on mass medication could impact on animal welfare and pointing to overprescription of antibiotics in human medicine as the main source of resistance.

However, professor Maureen Baker, Chair of the Royal College of General Practitioners, said on Monday, “GPs and our teams are doing an excellent job of reducing prescriptions for antibiotics, with the latest NHS figures showing a 2.6m decrease in UK general practice last year. But it’s not just the healthcare sector that has responsibility for curbing resistance to antibiotics; the agriculture sector must also play its part. If antibiotics continue to be given to livestock when they are not needed it will put patients at risk all over the world. We support the recommendations outlined in this letter and would urge the Secretaries of State to take them into serious consideration.”

The medics pointed out that mass medication of livestock, particularly of pigs and poultry, accounts for nearly 90% of all farm antibiotic use in the UK. Whilst using antibiotics as growth promoters has been banned in the EU, it remains legal to routinely administer antibiotics to whole groups of livestock before any disease has been diagnosed within the group.
 
Professor John Middleton, President of the Faculty of Public Health also commented on the letter’s publication; “The evidence linking the overuse of antibiotics in farming and resistance in human bacterial infections is extremely compelling. It is clear that more needs to be done to limit veterinary prescribing. The government must now listen to, and act on, the concerns of the medical community - and place public health at the heart of considerations around the future UK farm antibiotic-use policy.”

In March, the European Parliament voted to ban mass medication of livestock animals, but their decision still needs to be supported by the European Council and Commission to pass into law. The signatories to the letter in the Telegraph said the UK will soon be in a “Unique position” to implement experts’ recommendations; they said, “We urge the government to…immediately introduce a UK-wide ban on the routine preventative mass medication of animals, and to urgently curb farm use of the ‘critically important’ antibiotics.”

In a separate statement on Monday, Dr David McCoy, Director of health professionals’ campaign group Medact added, “The overuse of antibiotics in farming is part of a much larger problem with our food system and demand for cheap and abundant meat and animal products. Livestock can be reared without heavy reliance on antibiotics, if we improve animal husbandry and reverse the high consumption of meat in the UK.”

At a Joint Workshop on Antimicrobial Resistance in the Environment, held in Jiaxing, China last week, experts from the UK and China agreed to cooperate on research and monitoring work to tackle sources of antibiotic resistance in the environment.